AccountId: 011433970860
ContactId: 1ae050de-486a-4b3c-a489-c257fd1ce6be
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 248919 ms
Total Talk Time (AGENT): 100609 ms
Total Talk Time (CUSTOMER): 84241 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/1ae050de-486a-4b3c-a489-c257fd1ce6be_20250331T12:24_UTC.wav
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[AGENT][NEUTRAL] Yeah, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Advent Health imaging. I need to check patient benefits.
[AGENT][NEUTRAL] OK, I can barely hear you.
[CUSTOMER][NEUTRAL] I'm I audible now?
[AGENT][NEUTRAL] Yeah, I can't hear you.
[CUSTOMER][NEUTRAL] Yeah, this is [PII].
[AGENT][NEUTRAL] OK, and your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah. Actually, just now I called.
[AGENT][NEUTRAL] And did you say you're calling for claim status?
[CUSTOMER][NEUTRAL] No, this is for LGBT.
[AGENT][NEUTRAL] Eligibility? OK and what's the policy number?
[CUSTOMER][NEUTRAL] It's gonna be 20, just a moment. Let me do double check. Just give me a quick moment.
[AGENT][NEUTRAL] I'm sorry, I cannot hear you.
[CUSTOMER][NEUTRAL] 02
[CUSTOMER][NEUTRAL] 54
[CUSTOMER][NEUTRAL] 9493.
[AGENT][NEUTRAL] 02549493
[CUSTOMER][POSITIVE] Yeah, you're right.
[AGENT][NEUTRAL] And what is your phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[CUSTOMER][NEUTRAL] [PII] with the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you [PII]. I have the effective date for you. It's [PII]. Um, this policy is active at this time. Any other questions I could help out with today?
[CUSTOMER][NEUTRAL] May I know the plant type?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It's a supplemental gap policy, secondary to the major medical policy.
[CUSTOMER][NEUTRAL] OK, got you. And then, may I know the provider status? Could you please check the provider status?
[AGENT][NEUTRAL] Are you saying the provider status?
[CUSTOMER][NEUTRAL] Network status.
[CUSTOMER][NEUTRAL] Yeah, network status.
[CUSTOMER][NEUTRAL] With our facility.
[AGENT][NEUTRAL] You're needing
[AGENT][NEUTRAL] You're needing provider status?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, what do you mean?
[CUSTOMER][NEUTRAL] I may need to check the provider network status, whether we are in network or noted up with your policy.
[AGENT][NEUTRAL] What do you
[AGENT][NEUTRAL] Yeah, there is no network for this policy. We're secondary to the major medical plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have a procedure code here to check whether it is valid and billable or not.
[AGENT][NEUTRAL] OK, so you would just need to submit the claim, uh, we have to receive the claim for review before we can determine whether it's a covered item or not.
[CUSTOMER][NEUTRAL] OK. So you will not provide any benefit, right, before submitting the claim?
[AGENT][NEUTRAL] OK, you were asking about a procedure code, so do you want the benefit information and if so, is it outpatient facility or is it service in a doctor's office?
[CUSTOMER][NEUTRAL] Uh doctor's office for patient.
[AGENT][NEUTRAL] OK. Is it gonna be done in a hospital or a physician's office?
[CUSTOMER][NEUTRAL] Office
[AGENT][NEUTRAL] OK, you said office visit outpatient, that's two different things. So under this policy, the office visit co-pay is not covered?
[AGENT][NEUTRAL] Uh, covered treatment in the office can be considered.
[AGENT][NEUTRAL] So you could just submit the claim for review.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, anything else?
[CUSTOMER][NEUTRAL] That's all the information I need today.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] That's it. How do you spell your name?
[AGENT][POSITIVE] You too [PII] thank you for calling APL have a good day.
[CUSTOMER][NEUTRAL] How do you spell your name?
[AGENT][NEUTRAL] My name is [PII]. You'll use my name in today's date as your reference. [PII].
[CUSTOMER][POSITIVE] OK, [PII]. Thank you so much. Have a wonderful day. Bye for now.
[AGENT][POSITIVE] You're welcome thanks for calling APL have a good day.